Anorexia Nervosa: What you need to know

Anorexia nervosa, also called anorexia, is a potentially life-threatening eating disorder that is characterised by self-starvation and excessive weight loss. The disorder is diagnosed when a person weighs at least 15 per cent less than his or her normal/ideal body weight. Extreme weight loss in people with anorexia nervosa can lead to dangerous health problems and even death.

The term anorexia literally means "loss of appetite." However, this definition is misleading as people with anorexia nervosa are often hungry but refuse food anyway. People with anorexia nervosa have intense fears of becoming fat and see themselves as fat even when they are very thin. These individuals may try to correct this perceived "flaw" by strictly limiting food intake and exercising excessively in order to lose weight.

Causes of anorexia

The exact cause of anorexia is not known, but research suggests that a combination of certain personality traits, emotions, and thinking patterns, as well as biological and environmental factors might be responsible.

People with anorexia often use food and eating as a way to gain a sense of control when other areas of their lives are very stressful or when they feel overwhelmed. Feelings of inadequacy, low self-esteem, anxiety, anger, or loneliness also might contribute to the development of the disorder. In addition, people with eating disorders might have troubled relationships, or have a history of being teased about their size or weight. Pressure from peers and a society that equates thinness and physical appearance with beauty also can have an impact on the development of anorexia.

Eating disorders also might have physical causes. Changes in hormones that control how the body and mind maintain mood, appetite, thinking, and memory might foster eating disorders. The fact that anorexia nervosa tends to run in families also suggests that a susceptibility to the disorder might partially be hereditary.


Untreated, anorexia nervosa can lead to organ damage or drop in blood pressure, pulse and breathing rates. The patients often experience loss of hair or even thinning of bones, otherwise called osteoporosis. In extreme cases, anorexia could lead to death from starvation or even suicide if help is not received.


Emergency care for anorexia may be needed in some extreme cases where dehydration, malnutrition, kidney failure, or an irregular heartbeat may pose imminent risk to life.

Emergency or not, treatment of anorexia is challenging because most people with the disorder deny they have a problem – or are so terrified of becoming overweight that they may oppose efforts to help them gain a normal weight. Like all eating disorders, anorexia requires a comprehensive treatment plan that is adjusted to meet the needs of each patient.

Goals of treatment include restoring the person to a healthy weight, treating emotional issues such as low self-esteem, correcting distorted thinking patterns, and developing long-term behavioural changes. Treatment most often involves a combination of the following treatment methods:


This is a type of individual counseling that focuses on changing the thinking (cognitive therapy) and behaviour (behavioural therapy) of a person with an eating disorder. Treatment includes practical techniques for developing healthy attitudes toward food and weight, as well as approaches for changing the way the person responds to difficult situations.


Certain antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) might be used to help control anxiety and depression associated with an eating disorder. Some antidepressants may also help with sleep and stimulate appetite. Other types of medications also might be offered to help control anxiety and/or distorted attitudes toward eating and body image.


As mentioned above, hospitalisation might be needed to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications, such as heart disorders, serious depression, and risk of suicide. In some cases, the patient may need to be fed through a feeding tube or through an IV.


The symptoms often include the following:

• Rapid weight loss over several weeks or months

• Continuing to diet/limited eating even when thin or when weight is very low

• Having an unusual interest in food, calories, nutrition, or cooking

• Intense fear of gaining weight

• Strange eating habits or routines, such as eating in secret

• Feeling fat, even if underweight

• Inability to realistically assess one's own body weight

• Striving for perfection and being very self-critical

• Undue influence of body weight or shape on self-esteem

• Depression, anxiety, or irritability

• Infrequent or irregular, or even missed menstrual periods in females

• Laxative, diuretic, or diet pill use

• Frequent illness

• Wearing loose clothing to hide weight loss

• Compulsive exercising

• Feeling worthless or hopeless

• Social withdrawal

• Physical symptoms that develop over time, including: low tolerance of cold weather, brittle hair and nails, dry or yellowing skin, anemia, constipation, swollen joints, tooth decay, and a new growth of thin hair over the body